New research shows health risks of smoke exposure in gastrointestinal endoscopy

Editor's Note

Research presented at this year’s Digestive Disease Week in May highlights the potential health risks posed by smoke generated during tissue-cutting ablations in gastrointestinal (GI) endoscopy, Gastroenterology & Endoscopy News May 18 reports. Unlike surgeons in ORs, who follow specific regulations to mitigate smoke exposure, GI endoscopy procedures currently lack comparable guidelines, according to Christopher Thompson, MD, principal investigator and director of endoscopy at Brigham and Women’s Hospital in Boston.

Dr Thompson and his team used measurement devices to quantify the smoke exposure levels of surgeons, nurses, and technicians during various endoscopic procedures, including those for stopping bleeding, removing cancerous or precancerous polyps, and reducing the small intestine's opening during gastric bypass. The findings were concerning, notes the article, with argon plasma coagulation producing the highest smoke levels, comparable to cigarette smoke. Every procedure generated measurable smoke.

“Over the course of a career, endoscopic smoke may pose significant health risks, especially to technicians and nurses who are in endoscopy suites every day,” Dr Thompson told the outlet. The research team placed smoke measurement devices approximately one meter from the procedure site, revealing that peak levels of volatile organic compounds in the smoke reached twice the Environmental Protection Agency's maximum safe level. Additionally, ultrafine or fine inhalable particles were consistently present in the procedure room.

Possible solutions suggested include using devices to remove smoke or wearing different types of masks. Madhav Desai, MD, a gastroenterologist at UTHealth Houston not involved in the study, emphasized in the article the importance of this research as the number of smoke-generating procedures increases. He noted that while argon plasma coagulation is particularly smoke-intensive, more research is needed to fully understand which endoscopic methods produce the most smoke.